Avoidance of healthcare service use and correlates among HIV-positive patients in Vietnam: a cross-sectional study.
Date
2023-12
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Abstract
Objective
The prevention of HIV/AIDS is not making sufficient progress. The slow reduction of HIV/AIDS infections needs to prioritise hesitancy towards service utilisation, including treatment duration, social support and social stigma. This study investigates HIV-positive patients' avoidance of healthcare services and its correlates.Design
A cross-sectional study.Setting
The secondary data analysis used cross-sectional data from a randomised controlled intervention, examining the effectiveness of HIV-assisted smartphone applications in the treatment of HIV/AIDS patients in the Bach Mai and Ha Dong clinics in Hanoi.Methods
Simple random sampling was used to identify 495 eligible patients. Two-tailed χ2, Mann-Whitney, multivariate logistic and ordered logistic regression models were performed.Primary and secondary outcome measures
The main study outcome was the patients' healthcare avoidance and frequency of healthcare avoidance. The association of individual characteristics, social and behavioural determinants of HIV patients' usage of health services was also determined based on the collected data using structured questionnaires.Results
Nearly half of the participants avoid health service use (47.3%), while 30.7% rarely avoid health service use. Duration of antiretroviral therapy and initial CD4 cell count were negatively associated with avoidance of health services and frequency of health service avoidance. Similarly, those with the middle and highest income were more likely to avoid health services compared with those with the lowest income. People having health problems avoided health service use more frequently (OR 1.47, 95% CI 1.35 to 1.61).Conclusions
Our study's findings identify characteristics of significance in relation to health service avoidance and utilisation among HIV-positive patients. The results highlighted the need to improve satisfaction, adherence and utilisation of treatment. Moreover, identifying ways to address or incorporate those social determinants in new policy may also help the treatment of HIV/AIDS and strategically allocate funding in the changing financial and political climate of Vietnam.Trial registration number
Thai Clinical Trials Registry TCTR20220928003.Type
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Nguyen, Huong Lan Thi, Thu Minh Bui, Vu Anh Trong Dam, Tham Thi Nguyen, Hien Thu Nguyen, Ga Mei Zeng, Don Bradley, Quang N Nguyen, et al. (2023). Avoidance of healthcare service use and correlates among HIV-positive patients in Vietnam: a cross-sectional study. BMJ open, 13(12). p. e074005. 10.1136/bmjopen-2023-074005 Retrieved from https://hdl.handle.net/10161/30128.
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Don W. Bradley
Dr. Bradley began his career in a rural family practice and then joined the Duke Family Medicine faculty, where he served as medical director for the residency. He moved to Blue Cross and Blue Shield of North Carolina and served as Senior Vice President Healthcare and Chief Medical Officer.
He returned to Duke and served as Executive Director for the Practical Playbook, whose mission is to advance collaboration among public health, primary care, and others to improve population health. His team provided technical support for the BUILD Health Challenge- over 30 communities across the country with grants that brought community-based organizations, governmental public health, and healthcare systems to work on upstream drivers of health in their environments.
He is a member of the National Academy of Medicine Roundtable on Obesity Solutions Innovation Collaborative for Clinical and Social Systems for the Prevention and Management of Obesity and has served as a member of the Academy of Nutrition and Dietetics Board of Directors.
He did his undergraduate work at the University of Virginia, medical school at Virginia Commonwealth University (MCV), Family Medicine Residency in Harrisburg, PA, a Kellogg Fellowship at Duke, and a Master of Health Sciences in Clinical Leadership at Duke. He is a Fellow of the American Academy of Family Physicians.
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